INHALANTS - The University of Texas at Austin

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					      INHALANTS:
Not always who or what we
          think!
      Jane C. Maxwell, Ph.D.
     Richard T. Spence, Ph.D.
      Lynn S. Wallisch, Ph.D.
  Center for Social Work Research
   University of Texas at Austin
SURVEYS
        Survey Data Sources
• Johnson LD, O’Malley PM & Bachman JG. Monitoring the Future
  National Survey Results on Drug Use, 1975-2001. NIDA, 2002.
• Office of Applied Studies. Summary of Findings from 2001
  National Household Survey on Drug Abuse: Vol. II, SAMHSA
• Liu LY. 2002 Texas School Survey of Substance Use Among
  Students: Grades 7-12. Austin: TCADA, 2003.
• Liu LY & Maxwell JC. 2000 Texas School Survey of Substance
  Use Among Students: Grades 7-12. Austin: TCADA, 2001.
• Liu LY Maxwell JC & Wallisch LS.2000 Texas School Survey of
  Substance Use Among Students: Grades 4-6. Austin: TCADA
  2001.
• Wallisch LS & Kerber L. Substance Use and Delinquency Among
  Youths Entering Texas Youth Commission Facilities: 2000-2001.
  Austin: TCADA 2001.
• Office of Applied Studies. “Inhalant Use Among Youths, NHSDA
  Report, March 22, 2002.
 Use of Inhalants: AU & US
  Household Surveys 2001
10%
           8%
8%

6%                           Australia

4%                           United States
      3%

2%                     1%
                 0%
0%
      Lifetime   Past Year
          Lifetime Use of Inhalants for
          12th Graders: Monitoring the
           Future Survey: 1979-2001
          25


          20


          15
Percent




          10


           5


           0
               1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001
   % Youths 12-17 Reporting Lifetime
  Inhalant Use by Type: NHSDA 2000
                                 Anesthetics     0.4
            Lighter Gases (butane, propane)             1.0
                  Laquer Thinner & Solvents                      1.6

                      Other Aerosol Sprays                       1.7

                      Amyl Nitrite, Poppers                      1.7

                    Nitrous Oxide Whippets                             2.0

  Correction Fluid, Degreaser, Cleaning Fluid                          2.0
                                 Spray Paint                            2.2

                    Gasoline or Lighter Fluid                                 3.3

                               Glue, Toluene                                        3.9
“Inhalant Use Among Youths,” The NHSDA Report, March 22, 2002.
    % Persons Reporting Inhalant Use
     in AU Household Survey: 2001
                              14--19   20-29   30-39   40+

          8.0

          6.0
Percent




          4.0

          2.0

          0.0
                In Lifetime    In Last Year In Last Month In Last Week
% Persons Reporting Inhalant Use
 in AU Household Survey: 2001
3.5    3.3
3.0
2.5          2.0
2.0                                                   Male
1.5                                                   Female
1.0                 0.6
                          0.3   0.3
0.5                                   0.1   0.1 0
0.0
      In Lifetime   In Last     In Last     In Last
                     Year       Month       Week
% Youths 12-17 Reporting Past Year Inhalant
Use by Average Grade for Last Semester or
  Grading Period Completed: NHSDA 2000


 8.0                                7.2
 7.0
 6.0                      5.0
 5.0
 4.0             3.2
 3.0    2.1
 2.0
 1.0
 0.0
        A         B        C     D or Below
 % Students Who Had Ever Used
Inhalants or Marijuana by Grade:
   Monitoring the Future 2001
60%

50%
40%
                                      Inhalants
30%
                                      Marijuana
20%
10%

0%
      Grade 8   Grade 10   Grade 12
 % Texas Secondary Students
Who Had Ever Used Inhalants or
  Marijuana by Grade: 2002
60%
50%
40%
                                                Inhalants
30%
                                                Marijuana
20%
10%
0%
      Grade   Grade Grade Grade   Grade Grade
       7       8      9    10      11    12
 Percentage of Texas Students Who Had
   Ever Used Inhalants, by Grade and
Number of Different Inhalant Types Used:
                 2000
20%

15%
                                 4+ Types
10%                              2-3 Types
                                 1 Type
5%

0%
       10

       11

       12
        4

        5

        6

        7

        8

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  Use of Inhalants: Texas
Reform and Secondary School
   Surveys: 2000 & 2001
35%
       31%
30%
25%
20%          19%
                   16%         Reform School
15%
                         10%   Secondary School
10%
 5%
 0%
      Ever Used    Past Year
TREATMENT
ADMISSIONS
          Characteristics of All Clients
        Admitted to US Treatment: 2001
      80%
      70%
      60%
      50%
      40%
      30%
      20%
      10%
       0%




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                                               All Drugs    Inhalants
http://wwwdasis.samhsa.gov/webt/quicklink/US00.htm
  Alcohol or Drug Use Among
   US Adolescent Inhalant
       Admissions: 2000
Both Alcohol and Marijuana          54%
Marijuana Only                      12%
Marijuana & Drug Other than Alcohol 12%
Alcohol Only                         6%
Alcohol & Drug Other than Marijuana 4%
Other Drugs/Drug Combinations        3%
Used Inhalants Only                  9%
 Adolescent Admissions Involving Inhalants, The DASIS Report, March 14, 2002
 http://www.drugabusestatistics. Samhsa.gov/oas/2k2/inhalTX/inhalTX.htm
          Youth Admissions to TCADA
               Treatment: 2002
                                        25%
     % Psych Pbms                      23%


                                       23%                                              Inhalant n=84
    % Social Pbms                        27%                                            Total n=4,621

                                                        48%
    % Family Pbms                               37%

                                                      43%                                      Inhalants
  % Gang Involved                         29%
                                                                                               All Substances
                                                                     69%
    % CJ Involved                                                                 82%


                                                                      70%
            % Male                                                          76%


                                                                    66%
       % First Tmt                                                   68%



                      0%         20%            40%           60%          80%          100%
Texas Commission on Alcohol and Drug Abuse Client Oriented Data Acquisition Process
            Adult Admissions to TCADA
                 Treatment: 2002
                                                                    51%
     % Psych Pbms                                                   51%


                                                            42%
    % Health Pbms                                29%
                                                                                      Inhalant n=59
                                                                          56%         Total n=38,824
    % Family Pbms                                                   52%


                                 10%                                                     Inhalants
       % Emplolyed                        21%
                                                                                         All Substances
                                                              44%
     % CJ Involved                                           43%


                                                                                63%
             % Male                                                             63%


                                                   32%
       % First Tmt                                        40%


                       0%      10%     20%      30%     40%      50%      60%     70%
Texas Commission on Alcohol and Drug Abuse Client Oriented Data Acquisition Process
POISON CONTROL
    CENTERS
           National Toxic Exposure
         Surveillance System Inhalant
         Exposure Cases: 1996-2001
80%         74%
70%                                  54%
60%
50%                                                         41%
40%                                             30%
30%                     15%                                              13%
20%                                                                                   6%           6%
10%
 0%




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Spiller HA, Quadrani DA. Kentucky Regional Poison Center & Northern Colorado Medical Center
EMERGENCY ROOM
  DATA (DAWN)
 US DAWN ED Mentions of
 Inhalants by Age Groups:
        1994-2001
2500

2000
                                                 35+
1500
                                                 26-34
1000                                             18-25
                                                 Under 18
 500

   0
       1994 1995 1996 1997 1998 1999 2000 2001
   US DAWN ED Mentions of
Inhalants by Gender: 1994-2001
  2500

  2000

  1500
                                                   Female
  1000                                             Male

   500

     0
         1994 1995 1996 1997 1998 1999 2000 2001
 US DAWN ED Mentions of
     Inhalants by Drug
 Concomitance: 1994-2001
2500

2000

1500
                                                 Multi-Drug
1000                                             Single Drug

 500

   0
       1994 1995 1996 1997 1998 1999 2000 2001
 US DAWN ED Mentions of
  Inhalants by Drug Use
    Motive: 1994-2001
2500

2000
                                                 Other/Unk
1500
                                                 Suicide
1000                                             Dependence
                                                 Psychic Effects
 500

   0
       1994 1995 1996 1997 1998 1999 2000 2001
OVERDOSE DEATH
     DATA
    Deaths Associated with Inhalant Abuse in
    Virginia 1987-1996 and Texas 1988-1998

           60                                                              51
           50                         37
           40                                                                                       Va
                                                   24
           30       18
           20                                                           10                11        TX
                         5        5            2             1 3                      3
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Bowen SE, Daniel J, Balster RE, “Deaths associated with inhalant abuse in Virginia from 1987-1996,”
Drug and Alcohol Dependence 53 (1999) 239-245 and Maxwell JC, “Deaths related to the inhalation of
volatile substances in Texas: 1988-1998, American Journal of Drug and Alcohol Abuse 27, 2001, 689-698.
      Occupation by Type of Inhalant
     Mention, Texas Deaths: 1988-1998

        100%

          80%

          60%                                                                               Blue Collar
                                                                                            Mechanics
          40%
                                                                                            Student
          20%

            0%
                          Freon                  CHC                 Toluene
Maxwell JC, “Deaths related to the inhalation of volatile substances in Texas: 1988-1998,
American Journal of Drug and Alcohol Abuse 27, 2001, 689-698.
TEXAS PRISON &
REFORM SCHOOL
   SURVEYS
                Data Sources
     http://www.tcada.state.tx.us/research
• Substance Use and Delinquency Among Youths Entering Texas
  Youth Commission Facilities: 2000-2001
• Substance Use Among Offenders Entering the Texas
  Department of Criminal Justice-Substance Abuse Felony
  Punishment Facilities, 1998-2000
• Substance Use Among Female Inmates Entering the Texas
  Department of Criminal Justice-Institutional Division, 1998
• Substance Use Among Male Inmates: Texas Department of
  Criminal Justice-Institutional Division, 1998
• Substance Use Among Female Inmates: Texas Department of
  Criminal Justice-State Jail Division, 1998
• Substance Use Among Male Inmates: Texas Department of
  Criminal Justice-State Jail Division, 1998
   Number of Respondents by
 Number of Times Used Inhalants


                1-10    11-49    50+
         None
                Times   Times   Times
Reform
School   1220   326      107     98
Youth
Prison
Adults   2839   430      117    134
Lifetime Use of Specific Inhalants in
Texas Reform School and Secondary
     School Surveys: 2000-2001
             Poppers

       Nitrous Oxide

     Correction Fluid

       Airplane Glue

Other Aerosol Sprays                                                   Secondary School

     Lacquer/Toluene                                                   Reform School

     Octane Booster

               Freon

             Gasoline

         Spray Paint


                        0%   10%   20%   30%   40%   50%   60%   70%
Types of Inhalants Ever Used
      by Adult Inmates
      Octane Booster

         Other Gases

     Correction Fluid

        Other Sprays

                                                                                  Females
               Freon
                                                                                  Males
Other Paints/Thinners

             Gasoline

          Spray Paint

             Poppers


                        0%   5%   10%   15%   20%   25%   30%   35%   40%   45%
      Characteristics of Adult Inmate
      Drug Users by Whether or Not
           They Used Inhalants
80%
                                        Drugs & No Inhalants
70%
                                        Drugs & Inhalants
60%

50%

40%

30%

20%

10%

0%
      Never Married   Prior Treatment    Fair or Poor       Mean # Drugs
                                        Mental Health          Used
  Past Year Use of Drugs Prior to
  Incarceration Based on # Times
   Used Inhalants: Adult Inmates
100%
80%                                                           None
60%                                                           1--10
40%                                                           11--49
20%                                                           50+
 0%




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    Past Year Crimes Prior to
Incarceration Committed by Adult
             Inmates
80%

70%

60%

50%
                                                                    Drugs & No Inhalants
40%
                                                                    Drugs & Inhalants
30%

20%

10%

0%
      Property Crime   Violent Crime   Drug-Related   Gang Member
                                          Crime
    Criminal History of Adult
  Inmates by Number of Times
             Inhaled
20.0                                  None
                                      1-10 Times
15.0
                                      11-49 Times
10.0                                  50+ Times

 5.0

 0.0
       # Times    # Times in   # Times on    # Times in
       Arrested      Jail       Juv Prob       Prison
  Abuse and Dependence of Adult
             Inmates
DSM III-R dependence is 3 or more of 9 criteria; abuse is 1-2 of 9 criteria

90%
80%
70%
60%
50%
40%
30%
20%
10%
 0%
       Alcohol     Alcohol    Drug Abuse      Drug        Any          Any
       Abuse     Dependence                Dependence   Substance   Substance
                                                         Abuse      Dependence

                      Drugs & No Inhalants   Drugs & Inhalants
     Adult inmate inhalers were
 significantly more likely* than non-
              inhalers to:
• To have run away from home and to have
  been physically abused as a youth
• To have lived with a partner with both
  substance abuse and psychological
  problems
• To be depressed and have more mental
  health problems
• To be at greater risk of HIV and AIDS
*p<.0001
    Adult inmate inhalers were
significantly more likely* than non-
             inhalers to:
• To have committed more property, violent,
  drug & sex crimes in the past year
• To have been drunk or high on inhalants,
  cocaine, uppers, heroin or pot when
  committed the crime
• To belong to a gang and as a member sold
  pot or cocaine
*p<.0001
  Characteristics of Reform School
   Youth by Number of Times Ever
           Used Inhalants
70%
60%
50%
40%
30%
20%
10%
 0%
      Homeless >Month    Welfare Invest.    Belonged to Gang
                             Family

                  None    1--10    11--49    50+
 Past Year Use of Drugs Prior to
 Incarceration Based on # Times
  Used Inhalants: Reform School
100%

80%

60%

40%

20%

 0%
       Alcohol   Marijuana   Powder    Crack    Heroin   Inhalants
                             Cocaine

                     None     1--10    11--49    50+
    Past Year Crimes Committed by Reform
    School Youth Prior to Incarceration by
           Number of Times Inhaled
                                                None
     100%
      90%                                       1-10 Times
      80%
      70%                                       11-49 Times
      60%                                       50+ Times
      50%
      40%
      30%
      20%
      10%
       0%



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     Criminal History of Reform
     School Youth by Number of
           Times Inhaled
12                               None
                                 1-10 Times
10
                                 11-49 Times

 8                               50+ Times


 6

 4

 2

 0
        # Times Arrested   # Times in Jail
Comparison of Adult Prison
 Inmates and Adolescent
 Reform School Inmates
 Past Year Use of Cannabis Based
    on # Times Used Inhalants
100%
 90%
 80%
70%
60%
                                     TYC
50%
40%                                  TDCJ
30%
20%
10%
 0%
       None   1--10   11--49   50+
Past Year Use of Cocaine Based on
     # Times Used Inhalants
90%
80%
70%
60%
50%                                 TYC
40%                                 TDCJ
30%
20%
10%
0%
      None   1--10   11--49   50+
Past Year Use of Heroin Based on
     # Times Used Inhalants
25%

20%


15%
                                    TYC

10%                                 TDCJ


5%

0%
      None   1--10   11--49   50+
   Characteristics of Adult &
   Youth by Number of Times
            Inhaled
100%
 80%
 60%
 40%
 20%
  0%
       Youth Been in Adult Been in     Youth             Adult
        Treatment     Treatment      Substance         Substance
                                     Dependent     Dependent

                    None    1--10    11--49      50+
    Reform school youth inhalers
    were significantly more likely*
        than non-inhalers to:
• More likely to have been abused as children
• To be at risk of HIV/AIDS
• To be depressed, suicidal, or have other
  mental health problems
• To have ever been in a gang
• To have driven while intoxicated
• To have committed a drug-related crime
•   *p<.0001
   Treatment Implications
• Protocols evolving—see Draft Inhalant
  Treatment Guidelines at
  http://www.inhalants.org
• Standard treatment generally
  ineffective.
• Transient v. chronic users?
• Medical screening for organ impairment.
• Neurological/behavioral impairments.
• Use of other drugs and alcohol?
• Long-term detox to clear solvent toxins
  in fatty cells which affect cognitive
  functioning so can participate in
  treatment.
• Treatment may take 90-120 days.
• May not be appropriate for group or talk
  therapy.
• Neurocognitive rehabilitation?
• Impaired decision-making skills.
• Family involvement & inhalant history.
• Peer group history.

				
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